Why some people bruise more easily than others

It's happened to all of us. Glancing at our arms or legs, we notice a mysterious bruise, which seems to have cropped out of nowhere. While this is typically more a curiosity than a concern, if it's happening with regularity we may be led to wonder why we are so bruise prone. Are some people more susceptible than others and (aside from watching where they're going), is there anything they can do?

School of hard knocks

To go back to basics, bruises, also known as contusions, form a day or two after an injury. They are the result of the capillaries in our tissues leaking out blood, causing a bluish discoloration.

As Dr Roger Henderson explains: "Whenever there is damage to a blood vessel, a complicated clotting pathway is set in motion and blood flows out into the surrounding tissue. If this escaped blood is contained in the body tissue directly under the skin then this gives the characteristic appearance of a bruise."

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Dr Ahmed Bachelani, a GP at the Ash-Shifa Clinic, adds that the larger the blood vessel damaged, the greater the blood loss and the larger the bruise.

"Typically, as the body absorbs the old blood in the tissues the bruise colour changes from green to yellow over the next two to three weeks until it completely fades. Bruises are often also tender and the overlying skin swollen from the effect of the trauma and the ensuing inflammation," he says.

Age and gender play a role

Of course, while everyone bruises from time to time, there is a lot of individual variation. If you find yourself bruising at the slightest knock, it could be simply a factor of age and gender.

"For instance, as we get older our blood vessels, skin and the underlying tissues aren't as vibrant or robust to resist those previously innocuous bumps. Our elderly are thus more prone to bruising more frequently and with larger bruises," says Dr Bachelani.

There is also some evidence to suggest that women bruise more easily than men. This is probably due to the fact women's skin is thinner, and because of structural differences in the way the fat and collagen is organised. It may also be related to the fact women, on average, have a higher percentage of body fat, as well as to the way the hormone oestrogen impacts the blood vessel walls.

Check your medication

Certain types of medication can also contribute to easy bruising. One example is steroids, which are used for a wide range of conditions ranging from asthma to rheumatoid arthritis. These cause your skin to thin, giving you less protection against wear and tear.

Other drugs may thin your blood, or reduce its clotting ability, which can also contribute to easy bruising.

As Dr Henderson explains: "Heparin and warfarin are blood-thinning drugs, used for example after blood clots, and if the dosage of these is too high then easy bruising readily occurs. If this occurs then medical advice should always be sought, especially if the bruising is accompanied by other symptoms such as nosebleeds or bleeding gums. Even simple aspirin tablets can be enough to trigger the problem, especially if unwittingly combined with natural blood thinning substances such as garlic, vitamin E or ginkgo biloba."

When to worry

If you find yourself bruising a lot more than you used to, and without any obvious explanation, it is worth seeing your GP to rule out the possibility of a more serious health condition.

"Occasionally severe bruising that appears after seemingly trivial or unnoticed injuries can be a sign of leukaemia or other serious blood disorder. This should be medically assessed since blood tests will easily show whether there is any clotting abnormality present in the blood," says Dr Henderson.

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This is especially important if you've started noticing other symptoms, or if your bruises are taking longer than normal to heal.

"If you notice palpable lumps under your skin (neck, armpits or the groin), or are losing weight (without dieting) and suffer from regular night sweats then these would be causes of concern that need to be addressed sooner rather than later," says Dr Bachelani.

How can I speed up healing?

Most of the time, bruises are simply a fact of life, rather than indicative of any underlying medical issues. However, if you want to speed up bruise healing or reduce bruise size, there are several strategies you can follow.

To begin with, it may help to use a cold compress immediately after injury.

"In the case of any bruising, whether large or small, it is important to limit the blood loss under the skin once a trauma has occurred. Applying pressure to the area is an easy and effective method. With a cold compress, the body naturally shuts down the temperature sensitive capillaries in the skin, reducing any potential leakage of blood," says Dr Bachelani.

Another approach is to check your diet, as a deficiency of vitamin C can affect the health of your tissues.

"If you suffer from simple bruising only, and are otherwise fit and well, then taking vitamin C supplements may help – as can the old fashioned remedy of using horse chestnut extract directly on the bruise. This contains proteolytic enzymes that help," says Dr Henderson.

And if you want a pointer on what to avoid (apart from sharp edges and stray plantpots)?

According to Dr Bachelani: "Homeopathic remedies such as Arnica are widely used to reduce pain, swelling and bruising. However, recent scientific research has proven it worthless."

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